Publication Date
4-1-2018
Journal
The Texas Heart Journal
DOI
10.14503/THIJ-17-6238
PMID
29844744
Publication Date(s)
April 2018
Language
English
PMCID
PMC5940275
PubMedCentral® Posted Date
4-7-2018
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Keywords
Blood flow velocity, cardiomyopathy, hypertrophic/diagnostic imaging/physiopathology, echocardiography, heart sounds, heart ventricles/physiopathology, isometric contraction, phonocardiography
Copyright
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Abstract
A diastolic paradoxical jet flow, often seen in patients with hypertrophic cardiomyopathy, is a unique flow from the apex toward the base of the left ventricle during isovolumic relaxation. To date, this phenomenon appears to have been noninvasively detected only on echocardiograms. We report the case of a 43-year-old man with hypertrophic cardiomyopathy and a diastolic paradoxical jet flow, in whom cardiac auscultation revealed a soft S4, a systolic ejection murmur, and a low-pitched early diastolic murmur immediately after S2 at the apex. On comparing his echocardiographic findings with those on phonocardiograms and apexcardiograms, we confirmed that the unusual murmur coincided with the diastolic jet flow. To our knowledge, this is the first case in which heart murmurs associated with a diastolic paradoxical jet flow have been clearly described. Because these flows can increase the risk of adverse outcomes, detecting any associated murmurs by methods other than echocardiography is worthwhile, even in the era of advanced imaging techniques.